title: Neutral functional realignment orthosis prevents hand pain in patients with subacute stroke: a randomized trial.
abstract: OBJECTIVE
  To quantify the preventive effect of a neutral functional realignment orthosis on pain, mobility, and edema of the hand in subacute hemiparetic poststroke patients with severe motor deficits.
  
  
  METHODS
  Randomized trial.
  
  
  METHODS
  Rehabilitation center.
  
  
  METHODS
  Poststroke patients (N=30) with subacute hemiparesis and severe deficits of the upper limb were enrolled. Fifteen patients were randomized to a standard rehabilitation program without orthosis and 15 patients received an experimental orthosis in addition to their standard rehabilitation program.
  
  
  METHODS
  The orthosis group wore the neutral functional realignment orthosis for at least 6 hours daily.
  
  
  METHODS
  Hand pain at rest (visual analog scale), wrist range of motion (Fugl-Meyer Assessment subscale), and edema of hand and wrist (circumferences). Outcome measures were assessed at time of randomization and after 13 weeks between groups.
  
  
  RESULTS
  At baseline, 2 patients in each group complained about a painful hand. After 13 weeks, 8 subjects in the control group and 1 subject in the orthosis group complained of hand pain (P=.004). Mobility and edema evolved similarly in both groups.
  
  
  CONCLUSIONS
  Neutral functional realignment orthoses have a preventive effect on poststroke hand pain, but not on mobility and edema in the subacute phase of recovery.
authors.affiliation: Haute école de santé Geneva, HES-SO/University of Applied Sciences Western Switzerland, Geneva, Switzerland. Elisabeth.burge@hesge.ch
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bürge
authors.forename: Danièle
authors.initials: D
authors.lastname: Kupper
authors.forename: Axel
authors.initials: A
authors.lastname: Finckh
authors.forename: Susan
authors.initials: S
authors.lastname: Ryerson
authors.forename: Armin
authors.initials: A
authors.lastname: Schnider
authors.forename: Béatrice
authors.initials: B
authors.lastname: Leemann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D009989:Orthotic Devices; D010146:Pain / Q000503:physiopathology* / Q000534:rehabilitation*; D010147:Pain Measurement; D010291:Paresis / Q000503:physiopathology* / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome